Epigenetic plasticity and chemoresistance in cancer: mechanisms, biomarkers, and translational opportunities for real-world evidence (opens in new tab)

Chemoresistance remains a major barrier to durable cancer control and is increasingly understood as a dynamic process shaped not only by genetic selection, but also by epigenetically regulated changes in cellular state. Evidence supports a model in which a subset of tumor cells survives treatment through drug-tolerant persister states characterized by slow cycling, stress tolerance, transcriptional rewiring, and altered interactions with the tumor microenvironment. In this context, chromatin ...